Individual
MICHELE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
25 COURT ST, MONTPELIER, VT 05602-2812
(802) 229-9608
Mailing address
25 COURT ST, MONTPELIER, VT 05602-2812
(802) 229-9608
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
148
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008547
—
VT
01
—
BCBS
58618
VT
Enumeration date
01/10/2007
Last updated
07/08/2007
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